Orth H B, Hurwitz N, Lohri A, Weber W, Herrmann R
Departement Innere Medizin, Kantonsspital, Basel.
Dtsch Med Wochenschr. 1994 Sep 16;119(37):1235-8. doi: 10.1055/s-2008-1058827.
A 46-year-old woman was found to have localized lymphoplasmocytic lymphoma (low-malignancy non-Hodgkin lymphoma). Repeated recurrences required various chemotherapy courses with different drugs. Gamma heavy chains in serum and urine, as well as in blast cells in bone marrow, were first found 3 years later as part of a follow-up examination. When the lymphoplasmocytic lymphoma subsequently changed into a highly malignant disseminated large-cell lymphoma, the monoclonal gamma heavy chain-producing components no longer occurred. During continuing treatment and presumably selection of different cell clones the now terminal chemotherapy-resistant lymphoma again produced biclonal IgG heavy chains. The gamma heavy chain production added little to the histomorphological characterization of the underlying lymphoma, as well as its treatment and prognosis.
一名46岁女性被诊断为局限性淋巴浆细胞淋巴瘤（低恶性非霍奇金淋巴瘤）。反复复发需要使用不同药物进行多种化疗疗程。3年后，作为随访检查的一部分，首次在血清、尿液以及骨髓原始细胞中发现了γ重链。当淋巴浆细胞淋巴瘤随后转变为高恶性弥漫性大细胞淋巴瘤时，产生单克隆γ重链的成分不再出现。在持续治疗期间，可能由于不同细胞克隆的选择，目前对化疗耐药的终末期淋巴瘤再次产生了双克隆IgG重链。γ重链的产生对潜在淋巴瘤的组织形态学特征、治疗及预后的影响不大。
